Congress Quarterly

Editor's Note

Aug 30, 2018

Author: Martina Stippler

When Amazon emerged out of nowhere in the midnineties, the future seemed unsure for brick-and-mortar independent bookstores. Between 1995 and 2000, the number of independent bookstores plummeted 43 percent. First, the chain stores (Borders, Barnes & Noble) out-competed them on price, then Amazon on price and inventory availability.

But then a funny thing happened-technology reemergence-as Ryan Raffaelli, assistant professor in the Organizational Behavior Unit at Harvard Business School, called it. Independent booksellers successfully reframed their market primarily as community and secondarily as inventory. The Swiss watch industry underwent a similar shift, to lifestyle marketing, in the wake of digital watches.

What does the future have in store for healthcare, and neurosurgery especially? Changes in reimbursement always have been strong drivers of change. How will the practice of the future neurosurgeon look? What must we do to stay relevant and be leaders and pioneers of future care? These are all good questions, and hopefully this issue of the Congress Quarterly has some of the answers.

Our past president, Dr. Alan Scarrow, elaborates on disruption in healthcare leadership. Dr. Pedro Ramirez addresses disruption from the perspective of a private practice neurosurgeon, and I discuss how a more diverse neurosurgical workforce might challenge and change neurosurgery for the better.

Will only the infrastructure through which we deliver our care change, or also surgery and care itself? This notion is explored by Dr. Ron Alterman, a leading functional neurosurgeon in Boston, who explores the role artificial intelligence will play in medicine in general and neurosurgery specifically. We cannot have an issue that talks about disruption without exploring emerging technologies and how they will influence our role in the operating room. See Dr. Daniel Refai's and Dr. Osama Kashlan's feature on emerging technologies and Dr. Nicholas Theodore's piece on robots in spine surgery. Another possible paradigm shift in neurosurgery could be who will treat patients with mild complicated TBI care. Drs. Batjer, Aoun and Bellal are exploring this controversy.

If neurosurgery changes, the way we train the next generation of neurosurgeons must evolve too. One of the threats to, or opportunities for, neurosurgery-depending on whom you ask-is the question of whether spine surgery should be its own specialty. Read all about it in the Congress Quarterly.

Disruption-a threat to the status quo-is also an opportunity to gather and rethink our core values, strengths, and weaknesses and emerge better and stronger than before. This is exactly what happened in independent bookstores. Between 2009 and 2015, the number of independent booksellers grew by 35 percent. I hope you enjoy reading this issue as much as I enjoyed curating the content.

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